@article {Burgers00030-2018,
author = {Burgers, Jacobus Adrianus and Damhuis, Ronald Alphons},
title = {30-day mortality after the start of systemic anticancer therapy for lung cancer: is it really a useful performance indicator?},
volume = {4},
number = {4},
year = {2018},
doi = {10.1183/23120541.00030-2018},
publisher = {European Respiratory Society},
abstract = {Systemic treatment is the standard treatment for unresectable stage III and IV lung cancer. Nevertheless, a 5{\textendash}10\% death rate has been described within 30 days after the last systemic treatment, suggesting that these patient did not benefit. We analysed the 30-day mortality after start of systemic therapy.Data were retrieved from the Netherlands National Cancer Registry. From 2010 to 2015, 26 277 patients were included. 56\% were men. The median age was 65 years and 31\% of patients were aged >=70 years. 27\% involved small cell lung cancer and 73\% nonsmall cell lung cancer. Overall mortality within 30 days after the start of systemic treatment was 6.2\%. Multivariable analysis established the prognostic influence of age, histology, number of metastatic sites and type of systemic treatment. Chemotherapy was administered in 77 hospitals, treating each 15{\textendash}161 lung cancer patients with systemic therapy annually. None of the hospitals had a significantly higher 30-day mortality according to hierarchical multivariable analysis, controlling for case-mix.In the Netherlands, the 30-day mortality rate after start of systemic therapy for lung cancer patients was comparable with earlier reports. Hospital volume did not influence the 30-day mortality rate. 30-day mortality rate is not a meaningful indicator to monitor quality of care.30-day mortality rate after first-line systemic therapy for lung cancer does not seem to be a meaningful indicator to monitor quality of care http://ow.ly/2cWn30lDlpW},
URL = {http://openres.ersjournals.com/content/4/4/00030-2018},
eprint = {http://openres.ersjournals.com/content/4/4/00030-2018.full.pdf},
journal = {ERJ Open Research}
}